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CP2013

CP2013

ED, trauma
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CP2013 specializes in ED, trauma.

CP2013's Latest Activity

  1. CP2013

    Question about BLS cert. and CPR

    Ambu bags should be at locations near the bedside or hallway outside patient rooms. You should never really need to put your mouth on a patient in any healthcare setting. In a public setting, you can acquire and maintain a face shield that prevents some particle transmission.
  2. CP2013

    Why NOT private??

    And people do attend those accredited private schools. Every day. But the fact remains there are beliefs about these schools and they have a reputation among human resources regardless. Also many people blur the lines between private and for profit schools. As for wait lists, that shows the demand for the program, competitive nursing programs are not bad. Paying for a program you can get into is great but not everyone can do that. Many people who cannot wait to get in go to private scoops everyday. But second degree seeking students often can't get enough loan money because they are seeking a second undergraduate degree. There is a federal cap for undergraduate loans and not everyone can qualify for private loans instead.
  3. CP2013

    Why NOT private??

    Some human resource personnel disregard applicants who went to these types of schools. In Florida, grads from these types of schools often find themselves snowballed into a position they didn't want with no way out in sight. Also, occasionally these schools are approved by that state BON but are not accredited so you can't move forward in education without retaking classes. What is 5-10K now may end up 20-30K more later.
  4. CP2013

    Two Big Questions For Pain Experts

    I started reading through some of these and just stopped after a while. OP you said you needed this job and that's why you were there. If you ended up without a few seekers now and then and a few hypochondriacs for exploratory surgery....you might end up without a job. I'm not saying to blindly treat pain, but as MANY others have said, the FULL ASSESSMENT would be important to note. If 10mg of dilaudid isn't helping except to depress CNS, make a call to MD for a change of meds for better pain management. If patient is sleeping, I document "patient resting on bed with eyes closed, HR xx, BP xxx/xx, respirations xx/min, no acute distress noted at this time"...I don't wake someone to reassess pain. I don't. That's my nursing judgement. I think it's a better idea than waking up a patient for a sleeping pill like the nurse who cared for my mother. Pain IS what the patient says it is, because they are feeling it, even if we aren't seeing it. Take a look at people who get tattoos - some tolerate well, others end up with what looks like a butchered mess because they writhe in pain. Just because someone is stoic does not mean they don't experience pain. Some of it is cultural. In your first scenario, I would ASSESS the patients rationale for more pain medicine and delaying their discharge. I would inquire regarding how they intend to manage their pain without pain medicine. In your second scenario, I would ASSESS the type of surgery, health history (as discussed, bone or nerve pain is difficult to manage) and then utilize my critical thinking skills to determine what may be causing 10/10 pain. Their pain is perceived as a 10/10. Pain IS what they say it is. However my *intervention* is not to blindly give meds without using my CRITICAL THINKING and ASSESSMENT skills to determine if medication administration is indicated or necessary. I think that as a nurse if 30+ years OP, you should know better, as do most of the nurses on this forum have discussed. Nurses don't just hand out medication without thinking about it. (At least not GOOD nurses) We deserve more credit than that. Just because a doctor writes an order doesn't mean we don't double and triple check before it gets to the patient. If the MD orders 10mg dilaudid, obviously they are aware of the patients high tolerance level. I would have advised the MD that pain is still 10/10 but I had to arouse the patient via sternal rub and I'm concerned about excessive CNS depression and maybe we could try "insert drug here after ASSESSING patient allergies". Also, you work in PACU...let me just tell you that PACU nurses can be some of the bigger jerks when it comes to pain. I am EXTREMELY sensitive to anesthesia and am always difficult to arouse after surgery. I literally feel trapped in my body wanting to scream in pain but I am physically unable to form the words. When I wake up and say I have 10/10 pain, I assure you I am not a drug seeker with addiction problems, but that I have been suffering for a while and I am just now able to form the words. Never once has a nurse offered to further assess my pain to determine where or why, I never get additional pain medicine, I don't have an advocate asking the doctor for something more or something different. ONE time the physician's wife who took a special interest in me came to visit me in PACU and I managed to tell her I was hurting, so she went to her husband and asked for something. The nurse huffed when having to give it and said "do you want me to push it fast too?" I realize that not all nurses are like this however. Jut like you should realize that even though pain IS what the patient says it is, we look at the big picture and assess further. Pain (and even vital signs like BP and HR/rhythm) requires more assessment and determination before intervention - it's just not all black and white.
  5. There is a copay but most places don't bother to collect it because it causes more problems. One example, ED visits are a $3 copay after MSE but only one hospital collects it. The other hospital does full work up and doesn't ask for copay. Guess who gets all the MDCD patients? Yes, I have seen it first hand. Patients say that's why they chose one hospital.
  6. CP2013

    Working while in school

    After your first semester of nursing school you are eligible to apply for nursing assistant and nurse tech positions at either major hospital system. If you would prefer to work in home health or SNF/LTC/etc then they require a CNA certification from the state (which means taking the classes and then applying for state certification, and I believe Valencia has a program).
  7. CP2013

    New Grad, FL Hospital Heartland Division

    They do have a GN program but there is not an application for it. They utilize the same program of orientation but not as many education classes. Overall it's the same experience from my understanding from the new grads who went there.
  8. CP2013

    The Florida Hospital Graduate Nursing Program

  9. CP2013

    New Grad Jobs

    They seem to be hiring ALL the time. Someone said a lot of nurses go to Duke just for a few years to have it on their résumé and leave after 2-3 years and go elsewhere.
  10. CP2013

    Crazy old wives tales and odd customs...

    My parents still tell me not to go out of the house with wet hair. But I'll be damned if they probably haven't jinxed me cause every time I leave with wet hair or no socks just sandals, I seem to always catch a nasty cold. There's either some small truth to it, or I've been hexed!
  11. CP2013

    AACN Membership/CCRN

    Maybe for the alphabet soup at the end of your name?
  12. CP2013

    How do I get over this?

  13. CP2013

    Looking for adn-FNP online program with a low GPA

  14. CP2013

    Looking for adn-FNP online program with a low GPA

  15. CP2013

    Evaluate this situation. What did I miss?

    My first thought is that the IC Vanc might not have been effective. If patient temp was previously stable, it could be new infection or may be that the current infection is resistant to current therapies. Most facilities have parameters like "call for pt temp greater than x" and most places I have worked the temp greater than 101.5 or 102 would be reason enough to call.
  16. CP2013

    Amazing Sim Lab

    Don't forget the hot dogs to practice TSTs :)